| NPI | 1912421454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2174) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: ND 2174) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: MN 11169) | |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2025-04-30 |